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Side Effects and Warnings Flashcards

1
Q

Lipitor

A

Atorvastatin
CI: pregnancy, breastfeeding, liver disease

Warnings: muscle damage (increased CPK), use in elderly > 65 years), may increase A1c and FBG (but benefits outweigh the risk)

SE: myalgia/myopathy
hepatotoxicity/nephrotoxicity

Do NOT use with gemfibrozil

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2
Q

Which Statins should you take in the evening?

A

Lovastatin (Altoprev)
Simvastatin (Zocor)
FLuvastatin

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3
Q

Which statin should you take with a meal?

A

Lovastatin (Altoprev)

Take in the evening with a meal!

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4
Q

Pravacol

A

Pravastatin
CI: pregnancy, breastfeeding, liver disease

Warnings: muscle damage (increased CPK), use in elderly > 65 years), may increase A1c and FBG (but benefits outweigh the risk)

SE: myalgia/myopathy
hepatotoxicity/nephrotoxicity

Do NOT use with Gemfibrozil

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5
Q

Which statins should you AVOID with CYP3A4 inhibitors?

A

Lovastatin (Altoprev)
Simvastatin (Zocor)

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6
Q

What are the CYP3A4 inhibitors that should be avoided?

A

G PACMAN
Grapefruit
Protease Inhibitors
Amiodarone
Cyclosporine, Cobicistat
Macrolides (not Azithro)
Azoles
Non-DHP CCBs

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7
Q

Zetia

A

Ezetimibe
CI: pregnancy breastfeeding
Warning: avoid in hepatic impairment

SE: myalgias, diarrhea

Give Zetia 2 hours before bile acid sequestrant

DO NOT use with gemfibrozil (Lopid)

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8
Q

A patient is on Pravachol, Zetia, and Lopid for HLD and high TG. What is wrong with this regimen? What do you recommend?

A

Lopid (gemfibrozil) should NOT be used with statins or Zetia!!!!!!

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9
Q

Praluent

A

Alirocumab SC
SE: injection site rxns, URTI, increased LFTs

store in fridge, can be at room temp for up to 30 days

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10
Q

Repatha

A

Evolocumab
SE; injection site rxns, URTI, back pain

store in fridge, can be at room temp for up to 30 days

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11
Q

Welchol

A

Colesevelam
Bile acid sequestrant

CI: bowel obstruction, TG > 500, history of TG induced pancreatisis

SE: constipation, ab pain, cramping, bloating, gas, INCREASED TG

***not recommended when TG are >/= 300

**SAFE in pregnancy (:

DECREASED absorption of fat soluble vitamins KADE

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12
Q

Cholestyramine

A

Bile Acid Sequestrant
CI: biliary obstruction

SE: constipation, ab pain, cramping, bloating, gas, increased TG

**not recommended when TG are >/= 300

**use good oral hygeine!!! Enamel erosion or teeth discoloration!!!

DECREASED absorption of fat soluble vitamins KADE

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13
Q

Which drugs should be taken 4 hours PRIOR to colesevelam (Welchol)?

A

Levothyroxine
Cyclosporine
Glimepiride (Amaryl)
Glipizide (Glucotrol)
Glyburide (Glynase)
Olmesartan (Benicar)
Phenytoin
Oral contraceptions with Ethyl estradiol and Norethindrone

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14
Q

Antara

A

Fenofibrate
CI: severe liver disease or renal disease (CrCl < 30), gallbladder disease

Warning: myopathy, increased risk when coadministered with statin!!!!
SE: increased LFT, hypothyroidism, increased CPK

*** can increase LDL when TG are high :(

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15
Q

Tricor

A

Fenofibrate
CI: severe liver disease or renal disease (CrCl < 30), gallbladder disease

Warning: myopathy, increased risk when coadministered with statin!!!!
SE: increased LFT, hypothyroidism, increased CPK

*** can increase LDL when TG are high :(

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16
Q

Trilipix

A

Fenofibrate
CI: severe liver disease or renal disease (CrCl < 30), gallbladder disease

Warning: myopathy, increased risk when coadministered with statin!!!!
SE: increased LFT, hypothyroidism, increased CPK

*** can increase LDL when TG are high :(

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17
Q

Lopid

A

Gemfibrozil
CI: severe liver disease or renal disease (CrCl < 30), gallbladder disease

Warning: myopathy, increased risk when coadministered with statin!!!!
SE: increased LFT, hypothyroidism, increased CPK

*** can increase LDL when TG are high :(

***DO NOT USE WITH STATINS or ZETIA due to increased risk of myopathy and rhabdomyolysis

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18
Q

What lopid and warfarin are given in the same patient what can happen?

A

Wafarin efffects increase causing an INCREASED bleeding risk and INR

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19
Q

Niacin

A

CI: active liver disease, PUD, or arterial bleeding
Warning: rhabdomyolysis, hepatotoxicity

INCREASED BG and uric acid and LFTs

SE: FLUSHING, pruritis, vomiting, diarrhea, hyperglycemia, hyperuricemia (GOUT)

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20
Q

Niacor vs Niaspan vs Slo-Niacin

A

Niacor - IR formulation most flushing and itching

Niaspan - ER formulation
less hepatotoxicity AND less flushing ===== THE BEST CHOICE*****

Slow-Niacin - CR formulation
less flushing but more hepatotoxicity!!!

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21
Q

Vascepa

A

Icosapent ethyl
Warning: hypersensitivity to fish or shellfish

SE: eructation (burping), dyspepsia, arthralgias

**can increase LDL and BLEEDING RISK!

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22
Q

Lovaza

A

Omega-3 acid ethyl esters

Warning: hypersensitivity to fish or shellfish

SE: eructatin (burping), dyspepsia, taste perversions

***can increase LDL and BLEEDING RISK

23
Q

Which dyslipidemia drugs should you avoid in pregnancy?

A

STATINS + Zetia

24
Q

Which dyslipidemia drugs are SC and can be stored at room temp for up to 30 days?

A

Repatha
Praluent

25
Which dyslipidemia drugs affect the absorption of fat soluble vitamins KADE?
Bile acid sequestrants
26
Chlorthalidone
CI: hypersensivity to sulfonamide SE: hypo - K, Mg, Na hyper - Ca, UA, LDL, TG, BG, Lithium Photosensitivity Impotence (ED) DO NOT USE CrCl < 30 INCREASE Lithium levels
27
Hydrochlorothaizide
CI: sulfa allergy SE: hypo - K, Mg, Na hyper - Ca, UA, LDL, TG, BG, Lithium Photosensitivity Impotence (ED) DO NOT USE CrCl < 30 INCREASE Lithium levels and dofetilide to increase QTc
28
Norvasc
Amlodipine Warning: Hypotension SE: peripheral edema, HA, flushing, palpitations, gingical hyperplasia *substrate CYP3A4
29
Nicardipine IV
CI: advanced aortic stenosis Warning: chronic HTN or BP in non-pregnant adults DOC in pregnancy!!!!! *CYP3A4 substrate
30
Adalat CC
Nifedipine Warning: hypotension SE: peripheral edema, HA, flushing, palpitations, gingival hyperplasia, reflex tachycardia **used to prevent peripheral vasoconstriction in Raynaud's *CYP3A4 substrate
31
Clevidipine
CI: allergies to soy or eggs SE: hypotension, reflex tachy, infections!!!!! increases TG **contains 2 kcal/mL of lipid emulsion **time of use good for 12 hours after puncture!
32
Tiazac
Diltiazem CI: hypotension (SBP <90), heart block Warning: Heart failure!!!!!! bradycardia SE: edema, gingival hyperplasia, constipation (less than Calan) **CYP3A4 inhibitors and pgp substrates === lower dose of sim and lova
33
Calan
Verapamil CI: hypotension (SBP <90), heart block Warning: Heart failure!!!!!! bradycardia SE: edema, gingival hyperplasia, constipation (MORE than Tiazac) **CYP3A4 inhibitors and pgp substrates === lower doses of sim and lova
34
Lotensin
Benazepril BW: Pregnancy - death in developing fetus CI: angioedema, within 26 hours of Entresto Warning: angioedema, hyperkalemia, hypotension, renal impairment (increased SCr) bilateral renal artery stenosis SE: cough (blockage od bradykinin), hyperkalemia, increased SCr, hypotension
35
Vasotec
Enalapril BW: Pregnancy - death in developing fetus CI: angioedema, within 26 hours of Entresto Warning: angioedema, hyperkalemia, hypotension, renal impairment (increased SCr) bilateral renal artery stenosis SE: cough (blockage od bradykinin), hyperkalemia, increased SCr, hypotension
36
Prinivil
Lisinopril BW: Pregnancy - death in developing fetus CI: angioedema, within 26 hours of Entresto Warning: angioedema, hyperkalemia, hypotension, renal impairment (increased SCr) bilateral renal artery stenosis SE: cough (blockage od bradykinin), hyperkalemia, increased SCr, hypotension
37
Accupril
Quinapril BW: Pregnancy - death in developing fetus CI: angioedema, within 26 hours of Entresto Warning: angioedema, hyperkalemia, hypotension, renal impairment (increased SCr) bilateral renal artery stenosis SE: cough (blockage od bradykinin), hyperkalemia, increased SCr, hypotension
38
Altace
Ramipril BW: Pregnancy - death in developing fetus CI: angioedema, within 26 hours of Entresto Warning: angioedema, hyperkalemia, hypotension, renal impairment (increased SCr) bilateral renal artery stenosis SE: cough (blockage od bradykinin), hyperkalemia, increased SCr, hypotension
39
ACE and ARB drug interactions
Increase Lithium concentration!!!!! *** do not use RAAS inhibitors together
40
Avapro
Irbesartan like ACE inhibitors but - less angioedema - less cough - NO WASHOUT PERIOD with entresto
41
Cozaar
Losartan like ACE inhibitors but - less angioedema - less cough - NO WASHOUT PERIOD with entresto
42
Benicar
Olmesartan Warning: spruce like enteropathy (diarrhea with weight loss) like ACE inhibitors but - less angioedema - less cough - NO WASHOUT PERIOD with entresto
43
Diovan
Valsartan like ACE inhibitors but - less angioedema - less cough - NO WASHOUT PERIOD with entresto
44
Aldactone
BW: hyperkalemia (K >/= 5.5) CI: Addisons disease and severe renal impairment SE: hyperkameia, increased SCr, dizziness, gynecomastia, breast tenderness, impotence (blocks androgens) Increase Lithium concentration!!!!!
45
Eplerenone
BW: hyperkalemia (K >/= 5.5) CI: strong CYP3A4 inhibitors (Azoles, Clarithromycin, Ritonavir) SE: hyperkalemia, increase SCr, dizziness, hypertriglycerides Increase Lithium concentration
46
Triamterne
Hyperkalemia Increased Scr Dizziness INCREASE Lithium concentration (all diuretics!!!!)
47
Beta 1 selective blockers
"AMEBBA" Atenolol (Tenormin) Bisoprolol Esmolol (Brevibloc) Metoprolol tartrate (Lopressor) Metoprolol succinate (Toprol) Nebivolol (Bystolic BW: do NOT dc abruptly CI: heart block Warning: can worsen diabetes and mask symptoms of hypoglycemia, Raynaud's syndrome and other peripheral vascular diseases **preferred in COPD and asthma due to less beta-2 blockage (: SE: bradycardia, fatigue, hypotension, dizzines, depression, impotence, cold extremities
48
Beta-1 and 2 blockers
Propranolol (Inderal) Nadolol (Corgard) BW: do NOT dc abruptly CI: heart block Warning: can worsen diabetes and mask symptoms of hypoglycemia, Raynaud's syndrome and other peripheral vascular diseases SE: bradycardia, fatigue, hypotension, dizzines, depression, impotence, cold extremities
49
Coreg
Carvedilol BW: do not abruptly discontinue CI: severe hepatic impairment, heart block Warning: can worsen diabetes and mask symptoms of hypoglycemia, Raynaud's syndrome and other peripheral vascular diseases ***take ALL forms with FOOD!!!!!!!!! Carnivor EAT WITH FOOD SE: Edema, weight gain bradycardia, fatigue, hypotension, dizzines, depression, impotence, cold extremities
50
Labetalol
DOC in pregnancy CI: heart block Warning: can worsen diabetes and mask symptoms of hypoglycemia, Raynaud's syndrome and other peripheral vascular diseases BW: do not abruptly discontinue SE: dizziness, fatigue, bradycardia
51
Catapres
Clonidine Warning: do not abruptly dc SE: dry mouth, somnolence, fatigue, constipation, hypotension, bradycardia, impotence patch: pruritus, erythema, rash ****weekly patch that you muse remove before MRI
52
Methyldopa
CI: concurrent use with MAOi Warning: hemolytic anemia (postive Coombs test) SE: DILE, edema or weight gain
53
Hydralazine
Direct vasodilatory Warning: DILE SE: peripheral edema, HA, flushing, palpitations, reflex tachycardia

Cardiovascular (6 decks)

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